In the absence of a Medical Malpractice Law in the Philippines, it is the hope that this blogspot can serve as a vehicle to sensitize every Filipino to make sure they get proper health care from both doctors and hospitals.

Wednesday, January 23, 2008

Relleta's Complaint Letter to St. Luke's

Hello again!

Below is my friend's story. It's actually the letter of complaint she submitted to St. Luke's after the incident.

I would like to bring to your attention my complaint regarding the medication and diagnosis that was given to me by doctor Raymond Vincent Jurilla.

I went to his clinic to complain about my ear, which seemed to be clogged. I also gave him a brief history of what happened. I told him, almost 2 weeks before I came to see him, I was traveling uphill on a zigzag road and I felt so dizzy that time. I also felt sensation of some pressure in my ears, somewhat same as descending and ascending in an airplane. I never experienced being that dizzy before. Thinking that something maybe wrong with my cochlea, because I could not keep my balance, I decided to see an ear specialist last October 2. Doctor Jurilla was the ear specialist on duty that day. He requested that I should go for 3 tests: pure Tone Audiometry, Speech Audiometry (Oct 5)and VNG (Oct 8). I had all those tests there at St. Luke’s.

I went for my Audiometric Examination, the result of the examination was Mild Sensorineural hearing Loss; while the conclusion for my VNG was suggestive of positional vertigo.

On Ocotber 11, Dr Jurilla said, I have Meniere's Disease and Positional Vertigo, and prescribed the following: LASIX, duxaril and vit b-12. I took all the above that same day; but I took Lasix around early evening, since i wanted to sleep early that night. He said I should take it at bedtime. That’s all he said. After 2 hours of taking Lazix, I felt some dizziness and discomfort. I went to the bathroom to urinate and pass stool, but immediately after going to toilet , I felt so weak, I was sweating cold, and my world seemed to turn around, my body was cold, I was fainting. My son carried me, as I could not walk anymore. He made me sit down to relax, but I knew something really bad was happening to me after taking Lazix. My son took my BP and found that it had tremendously gone down to 70 and I had a hard time breathing. After 2 hours, I had another attack. This made me decide go to a hospital.

At the emergency room, the attendant and nurse took my ECG..there was T-wave, she said. I had Urinalisys, random blood sugar test, CBC tests. I requested to be allowed home the following day so I can better rest in my house.

After 4 days, I went to see an Internist doctor, who requested that I should see another Ear doctor and a Cardiospecialist on that same day and I did. This time, the Ear specialist was able to give a better diagnosis of my problem. She did endoscopy on my nose, looked at my ears, throat and found the reason. It was my sinus being clogged which affected my ears and was triggered when I was going uphill that time. AS SIMPLE AS THAT! And not Meniere's disease, as Dr Jurilla was saying. She prescribed medication and I am thankful that my ears feel better, though my body still has to recover.

Dr Jurilla, did not even ask me about my Blood Pressure, neither took time to get my BP before prescribing Lasix. I found out later that this will cause BP to fall. My normal BP is 100/70.

When I took Lazix, I had hypotension, and my sugar went to 165, I had hyperglycemia, and had difficulty of breathing. In other words, my condition worsened.

I have no intention to file case against the doctor. I just want to bring this to your attention and properly address the issue and concern.

People in the medical profession should try to be more dedicated in treating their patients. They are dealing with lives and not commodities. I hope we can do away with too much commercialism and politics in this field, rather more dedication and sincerity to serve.

15 comments:

Hi Kristina,I have a sister with the same symptoms as your friend she have a checkup in la salle.just like her they say she has a minieres/vertigo disease and right now taking the same medicine.I would like to know if you know the internist ear doctor who treated your friend maybe we can try that it would be big help from us.we are still hoping something else or maybe just an infiction in the ear that was not treated right away.i hope you can help us.Thank you very much contact through my email(jonthess29@yahoo.com.ph)

My response is to add another unfortunate case due to lack of Trauma Capability in one of the World’s best Hospital.

Recently a 66 yr old friend of mine of Belgian nationality, Mr. Daniel Masui ended up in St. Luke's Hospital with polytrauma following a holdup in his place of business in the heart of Manila. Daniel sustained a high velocity Gun Shot Wound to the face right maxillary region, bullet penetrating the soft palate with external loss of blood via mouth and nares. Transported to the hospital by pickup truck (no ambulance, luckily was stable with presenting with severe neck pain and profuse nasopharyngeal bleeding. and then the horrible medical inexperience began. Pertinent Physical exam showed the above GSW point of entry, stable admission Vital Signs, cervical, supraclavicular subcutaneous emphysema. Chest X-ray: minimal pneumothorax & hemothorax with bullet lodged right hemidiaphragm. Cervical X-ray comminuted Fracture of the C1 (ATLAS) (a very unstable fracture that would have required instant cervical stabilization and management to minimize potential respiratory & neurological compromise. Thereafter declining Vital Signs compromised hemodynamic clinical status 12hours post admission still without attention to cervical traction/immobilization. Patient hemodynamic status deteriorated, CPR instituted on his way to the Operating room for an intended chest tube placement. Patient expired prior to chest tube placement. With a high index of suspicion without cervical neck external traction/stabilization and management a highly contributory factor in respiratory arrest. The Hospital did not have an established Hospital Trauma care policy. The patient was electively managed and missed all the golden hour in trauma care. The neck never received cervical neck stabilization finally lead to the respiratory arrest at the 11th hour. This episode was totally preventable. Failure to stabilize a Cervical Neck Fracture (ATLAS, C1 Fx) either acute or delayed respiratory deterioration sooner or later will follow. This could have been avoided with elective nasotracheal intubation in this upper cervical spine fracture subtype. It requires a high index of suspicion and Recognition of airway compromise and impending insufficiency before clinical deterioration can be life saving. Patients with isolated C1 and C2 fractures should be assessed for the risk of developing airway compromise and that close monitoring may be required to detect this complication at an early stage. Daniel without provision of cervical immobilization developed delayed respiratory deterioration resulting to cardio-pulmonary arrest. Unstable C1 injury may present neurologically intact, but they are at grave risk for neurological compromise if not promptly diagnosed and appropriately stabilized and treated. Often an elective tracheostomy is essential because sooner or later the patient requires respiratory assistance and a volume respirator. Cervical traction should have been done on admission. Similarly Chest tube placement should have been done on admission at the emergency room and connected to pleurovac suction to monitor hemo/pneumothorax. Polytrauma admission belongs to General Surgery service on trauma call. GS on Trauma call should be the primary responder called to action by the ED physician. Luck of an established Trauma Care Policy lead to this unfortunate tragedy of events. Trauma level designation has not reached Philippine soil yet. Precisely why there is a Senate bill in Congress, Senate Bill 2279 sponsored by departing Senator Miriam Defensor Santiago who was recently elected to the United Nations to preside as a Judge at Hague.

It is important to get the word out on the petition Targeting the 15th Congress of the Republic of the Philippines to act on Senate Bill 2279 which seeks to Improve Emergency Medical Services and Trauma care by: (a) empowering the Department of Health to identify designated trauma centers, (b) establishing a National Clearinghouse on Emergency Medical Services and Trauma Care; and (c) providing for standards with respect to trauma care centers.This bill was originally filed during the 14th Congress 1" Regular Session.

A quick call to action by signing this petition to Tell the 15th Congress that it is about time to act quickly and pass Senate Bill 2279.

Get involved. Read the petition. Sign in to get Senator Miriam Defensor's Senate Bill 2279 pass this year 2012.Copy and paste this website: http://www.thepetitionsite.com/1/Get-Senate-Bill-2279-in-Advance-Trauma-Life-Support-in-the-Philippines-Congress/

The sooner we get the 15th Congress to act and pass Senator Miriam Defensor Santiago's Senate Bill 2279, an Act to Improve Emergency Medical Services and Trauma Care in the Philippines, the better for all Filipinos. On Nov 17, Mr. Ponciano C Cabuang Jr, CA signed and commented"It has to be done. Filipinos deserved better medical care. Govt official needs to act fast. I totally support this bill."

On Nov 30, Napoleon Relosa, CA signed the Petition"TO IMPROVE EMERGENCY MEDICAL SERVICES AND TRAUMA CARE in the Philippines embodied in Senate Bill 2279". Napoleon said in his comments,"Trauma care is important to be improved in the Philippines now. Persistently Behind the eight ball in Trauma Care leaves a patient in a difficult position from which it is unlikely to escape death, a high chance of losing life or limb and a short cut to the pearly gates. A sure way that is. So let's give life or limb a better chance. Pass Senate Bill 2279 NOW. That is mission possible.Having said that we definitely hope the 15th Congress act on it without further delay."

On Nov 15, Dr. Manuel Belandres, CA said in his comments,"It is important to recognize that Trauma care is one of the basic building blocks of a healthy neighborhood. It is important to recognize that Trauma is the leading cause of death in the first four decades of life. It makes a lot of sense implementing levels of trauma care and management to maximize rate of survival by improving Injury Severity Score [ISS], Glasco Coma Scale [GCS], Morbidity and Mortality [M&M] rates. All the values that every physician, nurse, and hospital care, prize, and immortalize. At its best Senate Bill 2279 allows a Trauma Care roadmap to exist, enfold and develop to a stable bond of hospital interdisciplinary team approach with an integrated and comprehensive policy to implement a regionalized trauma care systems as well as developing a pre-hospital triage criteria with reasonable sensitivity and expectation.Yes I surely will. It is important that Senate Bill 2279 be passed and enacted to elevate the levels of Trauma Care and management."Copy and paste http://www.thepetitionsite.com/1/Get-Senate-Bill-2279-in-Advance-Trauma-Life-Support-in-the-Philippines-Congress/#letter to sign. Spread the word.

What an eye opener. Not only will it improve & Elevate Emergency Medical Services & Levels of Trauma Care but it will open positions for Medical, Nursing & Paramedical staff who are in the Philippines. All private teaching Hospitals will benefit to expand their care to Trauma Level 1 within their existing residency & fellowship training program. Lower level Hospitals will have standardized direction to implement & follow Trauma guidelines according to the level of care they can provide which will improve their overall care by passage of this Bill. 15th Congress it is the right thing to do to get this senate Bill and its counterpart on the lower house passed. Why seek further delay. There is so much to be gained.344. Myrna Brauch Jul 2, 2012 Placerville, CA

This is the right thing to do.336. Vince Bogan Jun 28, 2012 Lorton, VA

I fully agree with #334, a road map to Trauma Care acquisition to the highest degree every Filipino will be proud of. Let's get Hospital Trauma Levels of Care established to maximize care and minimize morbidity & mortality rates in Trauma care. 15h Congress Please heed and pass this bill. It is the right thing to do.335. roberto valenton May 22, 2012 Pasadena, CA334. Ernie C. Mendoza May 17, 2012 Houston, TX

Pay attention to the 2nd leading cause of death in the Philippines. Without mandated Hospital designations of Levels of Trauma Care Level 1, Level 2, Level 3, Level 4 & Level 5, Hospital Trauma Care and Management will continue to be substandard. This Bill will be a road map to Trauma Care acquisition to the highest degree every Filipino will be proud of.